Faulty Brain Chemistry Linked to Sleep Apnea

Researchers have found links between deficits in brain chemistry and obstructive sleep apnea (OSA) and rapid-eye-movement (REM) sleep behavior disorder. Their findings were reported in the July 8, 2003, issue of Neurology.

Patients who have multiple system atrophy (MSA), a rare and fatal degenerative neurologic disease, almost always have severe sleep disorders. Researchers used neurochemical brain scans by positron emission tomography (PET) and single photon emission computed tomography (SPECT) and detailed sleep studies to study 13 patients with MSA. Compared to 27 control subjects, the MSA patients showed a far lower density of certain neurons that produce the key chemicals dopamine and acetylcholine. The lower the density, the worse their sleep problems were.

The researchers, from the University of Michigan Health System (U-M, Ann Arbor, MI, USA), chose MSA patients because of their extremely high incidence of OSA and other sleep problems, their disease's tendency to cause degeneration of certain nerve cells in the brain and spinal cord, and evidence that their sleep problems can be treated with medications that replace lost dopamine.

"It's exciting to be able to show this major neurochemical deficit for the first time and confirm what others have suspected,” says lead author Sid Gilman, M.D., professor and chair of the department of neurology at the U-M Medical School. Dr. Gilman's team is now recruiting patients with Parkinson's disease for a similar study, because they suspect that sleep disorders may be an early symptom in many cases.




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